| Koinonia Family Services | |
|
114 E Shaw Ave Ste 210 Fresno CA 93710-7621 | |
| (559) 230-0920 | |
| Not Available |
| Full Name | Koinonia Family Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 114 E Shaw Ave Ste 210, Fresno, California |
| Authorized Official Name and Position | Tiffany Danielle Sickler (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9166525802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koinonia Family Services Po Box 1403 Loomis CA 95650-1403 Ph: (951) 587-4165 | Koinonia Family Services 114 E Shaw Ave Ste 210 Fresno CA 93710-7621 Ph: (559) 230-0920 |
| NPI Number | 1104361146 |
|---|---|
| Provider Enumeration Date | 12/29/2016 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104361146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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